URCIA, ARIANNA VICTORIA B.

SURGERY DESCRIPTION INDICATION NURSING RESPONSIBILITY

1. Nephrectomy It is a surgical procedure Renal tumor Preoperative:
to remove all or part of a Polycystic kidneys Ensure adequate fluid
kidney: that are bleeding or intake & normal
Complete severely infected electrolyte balance
nephrectomy. Massive traumatic Tell that there will
During a complete injury to the kidney probably be a flank
(radical) Elective removal of incision that it will
nephrectomy, the a kidney from a require a
surgeon removes donor hyperextended, side-
the entire kidney. Obstruction (calculi) lying position (may
Partial Correct congenital experience muscle
nephrectomy. In a abn aches after surgery)
partial Divert urine when Ensure that one kidney
nephrectomy, the necessary works efficiently
surgeon removes Remove diseased Obtain informed consent
diseased tissue kidney Educate on the
from a kidney and procedures &
leaves healthy expectations of the
tissue in place. surgery
Enc. Verbalization of
feelings
Intraoperative:
Assure clients safety
Assist surgeon/ medical
team during operation
Postoperative:
Monitor patient status
(VS & consciousness)
Measure urine output &
record at least every 1
URCIA, ARIANNA VICTORIA B.
2. Laparoscopic It is a minimally invasive
Nephrectomy technique, which provides
patients with less
discomfort and equivalent
results when compared to
the larger incision
required with traditional
open surgery. When
or 2 hrs
Do not clamp or irrigate
the catheter or tube w/o
specific order
Total urine output (N:
>0.5 ml/kg/hr)
Assess urine drainage &
estimate amt
Observe color &
consistence of urine
Note for increased amts
of mucus, blood or
sediment that may
/occlude drainage tubing
Weigh patient daily
using the same scale,
clothes & time
Assess resp status
Give adequate pain
meds as ordered
Adm antibiotics as
ordered
Enc. Early ambulation,
cough & DBE
Obtain kidney from Preoperative:
a living donor to be Ensure adequate fluid
transplanted intake & normal
Removal of electrolyte balance
diseased kidney Inform patient it will be
performed through 5
puncture sites
URCIA, ARIANNA VICTORIA B.
compared to conventional
open surgery,
laparoscopic nephrectomy
has resulted in
significantly less post-
operative pain, a shorter
hospital stay, earlier
return to work and daily
activities, a more
favorable cosmetic result
and outcomes identical to
Intraoperative:
that of open surgery
Postoperative:
Position: Supine
Ensure that one kidney
works efficiently
Obtain informed consent
Educate on the
procedures &
expectations of the
surgery
Enc. Verbalization of
feelings
Assure clients safety
Assist surgeon/ medical
team during operation
Monitor patient status
(VS & consciousness)
Measure urine output &
record at least every 1
or 2 hrs
Do not clamp or irrigate
the catheter or tube w/o
specific order
Total urine output (N: 30
ml/kg/hr)
Assess urine drainage &
estimate amt
Observe color &
consistence of urine
Note for increased amts
URCIA, ARIANNA VICTORIA B.
3. Urinary Diversion It is when the normal
structures are bypassed
and an opening is made in
the urinary system to
bring the urine out
another way. This might
need to be done if your
bladder stops working the
right way or needs to be
removed because of
cancer or an injury. The
flow of urine is diverted to
a replacement bladder
("neobladder") or through
an opening in the
abdominal wall (called a
"stoma"). These are the
types of UD:
Ileal Conduit
Cutaneous
Ureterostomy
Nephrostomy
of mucus, blood or
sediment that may
occlude drainage tubing
Weigh patient daily
using the same scale,
clothes & time
Assess resp status
Enc. Early ambulation,
cough & DBE
Cancer of the Preoperative:
bladder Assess the ability &
Neurogenic bladder readiness to learn before
Congenital initiating teaching
defects/anomalies program & make
Strictures adjustment as needed
Trauma to the Involve pts family in the
bladder teaching process
Chronic Infections Discuss social aspects of
w/ deterioration of living w/ a stoma
renal function (clothing, body image &
sexuality changes,
exercise & odor)
Teach pt w/ a continent
diversion (Indiana
pouch) to catheterize at
least 6 hrs & irrigate the
pouch daily
Advise to adhere to a
strict catheterize sched
Intraoperative:
Assure clients safety
URCIA, ARIANNA VICTORIA B.

Assist surgeon/ medical

team during operation
Postoperative:
Monitor pt status (VS &
consciousness)
Prevent surgical
complications
Keep pt on NPO
Insert NGT as ordered
Prevent injury to the
stoma & maintain urine
output
Advise pt that mucus in
the urine is a normal
occurrence
Advise to increase OFI
(2-3 L/day)
Health teaching on
ostomy care
Apply appropriate
fitting ostomy
appliance (0.1
inch larger than
stoma)
Advise to monitor
stoma/surroundin
g tissue
Change & empty
ostomy bag
Refrain from using
alkaline soap
around the stoma
URCIA, ARIANNA VICTORIA B.

Educate on how
to monitor for
complications
4. Cystoscopy It is a procedure that Investigate Preoperative:
allows your doctor to causes of signs Ensure adequate fluid
examine the lining of your and intake & normal
bladder and the tube that symptoms.Those electrolyte balance
carries urine out of your signs and Position: Dorsal
body (urethra). A hollow symptoms can recumbent
tube (cystoscope) include blood in the Obtain informed consent
equipped with a lens is urine, incontinence, Educate on the
inserted into your urethra overactive bladder procedures &
and slowly advanced into and painful expectations
your bladder. urination. Enc. Verbalization of
Cystoscopy can also feelings
help determine the Adm preop drugs
cause of frequent (antibiotics) as ordred
urinary tract Enc to void
infections. Intraoperative:
However, Assure clients safety
cystoscopy Assist surgeon/ medical
generally isn't done team during operation
while you have an Postoperative:
active urinary tract Monitor pt status (VS &
infection. consciousness)
Diagnose bladder Prevent surgical
diseases and complications
conditions. Examp Adm pain meds if
les include bladder necessary & ordered
cancer, bladder Educate pt on how to
stones and bladder monitor complications:
URCIA, ARIANNA VICTORIA B.

inflammation An inability to
(cystitis). urinate after
Treat bladder cystoscopy
diseases and Bright red blood
conditions. Special or heavy blood
tools can be passed clots in your urine
through the Abdominal pain
cystoscope to treat and nausea
certain conditions. Chills
For example, very A fever higher
small bladder than 101.4 F (38.5
tumors might be C)
Pain or burning during
removed during
urination that lasts more
cystoscopy.
than two days
Diagnose an
enlarged
prostate. Cystosco
py can reveal a
narrowing of the
urethra where it
passes through the
prostate gland,
indicating an
enlarged prostate
(benign prostatic
hyperplasia).
5. Percutaneous It is a procedure used to Large kidney stones Preoperative:
Nephrolithotomy remove kidney stones are blocking more Ensure adequate fluid
from the body when they than one branch of intake & normal
cannot pass on their own. the collecting electrolyte balance
This procedure uses small system of the Position: Prone
URCIA, ARIANNA VICTORIA B.
telescopes and
instruments inserted
through a small incision in
your back to remove the
kidney stones.
kidney, also known Ensure that one kidney
as staghorn kidney works efficiently
stones Obtain informed consent
Kidney stones are & lab/dx tests
larger than 0.4 to Educate on the
0.6 inch (1 to 1.5 procedures &
centimeter) in expectations of the
diameter surgery
Large stones are in Enc. Verbalization of
the ureter feelings
Other therapies Intraoperative:
have failed
Assure clients safety
The person is obese
Assist surgeon/ medical
team during operation
Postoperative:
Monitor patient status
(VS & consciousness)
Measure urine output &
record at least every 1
or 2 hrs
Do not clamp or irrigate
the catheter or tube w/o
specific order
Total urine output (N:
>0.5 ml/kg/hr)
Assess urine drainage &
estimate amt
Observe color &
consistence of urine
Note for increased amts
URCIA, ARIANNA VICTORIA B.

of mucus, blood or
sediment that may
occlude drainage tubing
Weigh patient daily
using the same scale,
clothes & time
Assess resp status
Give adequate pain
meds
Enc. Early ambulation,
cough & DBE